JAMA:5岁前的谷蛋白摄入或增加遗传高危儿童的乳糜泻风险
创作:szx 审核:szx 2019年09月11日
  • 纳入6605名新生儿(携带与1型糖尿病及乳糜泻相关的HLA基因型),中位随访9.0年,记录5岁之前的谷蛋白摄入,分析乳糜泻与谷蛋白摄入的关联;
  • 随访期间,1216名(18%)儿童发展出乳糜泻自身免疫,447名(7%)儿童发展出乳糜泻;
  • 乳糜泻自身免疫及乳糜泻发生的高峰期在2-3岁期间,谷蛋白摄入与较高的乳糜泻自身免疫及乳糜泻风险相关;
  • 每天多摄入1g谷蛋白,乳糜泻自身免疫及乳糜泻风险分别增加6.1%及7.2%。
主编推荐语
szx
JAMA上发表的一项前瞻性出生队列研究结果,对超过6000名乳糜泻遗传高危儿童进行了近10年的随访后发现,5岁前的谷蛋白摄入与乳糜泻自身免疫及乳糜泻风险呈正相关。
关键字
延伸阅读本研究的原文信息和链接出处,以及相关解读和评论文章。欢迎读者朋友们推荐!
图片
JAMA [IF:45.54]

Association of Gluten Intake During the First 5 Years of Life With Incidence of Celiac Disease Autoimmunity and Celiac Disease Among Children at Increased Risk

5岁前的谷蛋白摄入与高危儿童的乳糜泻自身免疫及乳糜泻发生率之间的关联

10.1001/jama.2019.10329

2019-08-13, Article

Abstract & Authors:展开

Abstract:收起
Importance: High gluten intake during childhood may confer risk of celiac disease.
Objectives : To investigate if the amount of gluten intake is associated with celiac disease autoimmunity and celiac disease in genetically at-risk children.
Design, Setting, and Participants : The participants in The Environmental Determinants of Diabetes in the Young (TEDDY), a prospective observational birth cohort study designed to identify environmental triggers of type 1 diabetes and celiac disease, were followed up at 6 clinical centers in Finland, Germany, Sweden, and the United States. Between 2004 and 2010, 8676 newborns carrying HLA antigen genotypes associated with type 1 diabetes and celiac disease were enrolled. Screening for celiac disease with tissue transglutaminase autoantibodies was performed annually in 6757 children from the age of 2 years. Data on gluten intake were available in 6605 children (98%) by September 30, 2017.
Exposures : Gluten intake was estimated from 3-day food records collected at ages 6, 9, and 12 months and biannually thereafter until the age of 5 years.
Main Outcomes and Measures : The primary outcome was celiac disease autoimmunity, defined as positive tissue transglutaminase autoantibodies found in 2 consecutive serum samples. The secondary outcome was celiac disease confirmed by intestinal biopsy or persistently high tissue transglutaminase autoantibody levels.
Results : Of the 6605 children (49% females; median follow-up: 9.0 years [interquartile range, 8.0-10.0 years]), 1216 (18%) developed celiac disease autoimmunity and 447 (7%) developed celiac disease. The incidence for both outcomes peaked at the age of 2 to 3 years. Daily gluten intake was associated with higher risk of celiac disease autoimmunity for every 1-g/d increase in gluten consumption (hazard ratio [HR], 1.30 [95% CI, 1.22-1.38]; absolute risk by the age of 3 years if the reference amount of gluten was consumed, 28.1%; absolute risk if gluten intake was 1-g/d higher than the reference amount, 34.2%; absolute risk difference, 6.1% [95% CI, 4.5%-7.7%]). Daily gluten intake was associated with higher risk of celiac disease for every 1-g/d increase in gluten consumption (HR, 1.50 [95% CI, 1.35-1.66]; absolute risk by age of 3 years if the reference amount of gluten was consumed, 20.7%; absolute risk if gluten intake was 1-g/d higher than the reference amount, 27.9%; absolute risk difference, 7.2% [95% CI, 6.1%-8.3%]).
Conclusions and Relevance: Higher gluten intake during the first 5 years of life was associated with increased risk of celiac disease autoimmunity and celiac disease among genetically predisposed children.

First Authors:
Carin Andren Aronsson

Correspondence Authors:
Daniel Agardh

All Authors:
Carin Andren Aronsson,Hye-Seung Lee,Elin M Hård af Segerstad,Ulla Uusitalo,Jimin Yang,Sibylle Koletzko,Edwin Liu,Kalle Kurppa,Polly J Bingley,Jorma Toppari,Anette G Ziegler,Jin-Xiong She,William A Hagopian,Marian Rewers,Beena Akolkar,Jeffrey P Krischer,Suvi M Virtanen,Jill M Norris,Daniel Agardh,for the TEDDY Study Group

评论